• 한국농촌간호학회지
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• 제8권2호
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• pp.65-73
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• 2013

Purpose: The purpose of this study was to identify the relationship between intention to use advance directives and level of death anxiety in community-dwelling elders. Method: The participants were 200 older adults who were aged 60 or over and attended the community welfare centers. The level intention to use advance directive was measured by a questionnaire that was developed by the authors for the study. The measure by Kraus and Ellisond was administered to evaluate the level of death anxiety. Result: The average score for intention to use advance directives was $2.05{\pm}0.88$ and that of death anxiety was $6.2{\pm}2.28$. There were significant differences in the intention to use advance directives according to education levels and individual properties. Although there was no significant relationship between the intention to use advance directives and the level of death anxiety, they were negatively associated. Therefore, older adults who had lower death anxiety would tend to use advance directives. Conclusion: It would be necessary to screening the level of death anxiety to promote use of the advance directives. In addition, education programs for advance directives would be essential to consider about advance directives for their end-of-life especially for the community-dwelling elderly in Korea.

• Journal of Hospice and Palliative Care
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• 제11권2호
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• pp.73-77
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• 2008

• 대한전기학회:학술대회논문집
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• 대한전기학회 2002년도 하계학술대회 논문집 A
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• pp.533-535
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• 2002

In Korea, power requirement has been increasing. But the large generation unit is hardly installed because of economic and environment problem. Therefore, the concern of dispersed generation system(DGS) is growing. The power distribution system is generally operated with radial type. The protection system is composed of one directive source. But power distribution system inserted DGS changes it to two directive source system. Therefore, the insertion of DGS has the problem of protection coordination. In this paper, we argue fault current affected by interconnected DGS. We analyze fault current flow affected by DGS placement. Then, we find protective coordination problem. Consequently, we study advance point for protection scheme of power system interconnected DGS.

• 한국간호교육학회지
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• 제25권2호
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• pp.227-237
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• 2019

Purpose: The purpose of this study was to identify nursing students' knowledge and attitude toward advance directives and factors influencing the attitude. Methods: A cross-sectional survey design was used and 196 nursing students participated in the study. Data were collected from July 1 to August 30, 2018 using a structured questionnaire which included biomedical ethics, awareness of good death, knowledge and attitude toward advance directives. Data were analyzed using SPSS/WIN 25.0 program with descriptive statistics, t-test, ANOVA, correlation, and multiple regression. Results: The mean score of biomedical ethics, awareness of good death, knowledge and attitude toward advance directives were $2.88{\pm}0.59$, $3.18{\pm}0.48$, $7.68{\pm}31.32$, $31.00{\pm}3.09$. Factors influencing the attitude toward advance directives were awareness of good death (${\beta}=.28$, p<.001), intention of writing their advance directives (${\beta}=.19$, p=.006), the knowledge related to advance directives (${\beta}=.15$, p=.029). A total of 14% of attitude toward advance directives was explained by awareness of good death, the knowledge related to advance directives, and ntention of writing their advance directives. Conclusion: The findings of the study indicate that it is necessary to provide a systemic education program regarding advance directives for nursing students in order to provide knowledge related to advance directives and to help them establish positive attitudes toward advance directives.

• 의료법학
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• 제24권4호
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• pp.103-128
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• 2023

현행 연명의료결정법에 따르면 연명의료를 시행하지 않거나 중단하는 결정은 임종과정에 있는 환자의 의사가 우선적으로 적용된다. 이러한 환자를 대상으로 하는 연명의료의 의사결정은 환자가 의식이 있는 경우에는 환자 본인이 연명의료에 대한 의사를 직접 서면이나 구두로 표시하거나 사전연명의료의향서와 연명의료계획서를 작성하는 것으로 자기결정을 행사할 수 있다. 반면에, 환자가 사전연명의료의향서나 연명의료계획서를 작성하지 않은 경우에는 환자 가족의 진술로 환자의 의사를 확인하거나 환자가족 전원의 동의로 연명의료중단등결정을 할 수 있다. 그러나 가족이 없거나 가족을 알 수 없는 무연고 환자인 경우에는 입원하기 전에 사전연명의료의향서와 연명의료계획서를 작성하지 않은 상태에서 의사표현을 할 수 없는 의학적 상태로 되면 환자의 의사를 알 수가 없어 환자에 대한 연명의료를 지속해야 할지 중단해야 할지에 대한 결정을 해야 하는 상황이 발생한다. 본 연구는 무연고환자의 경우에 연명의료결정을 위한 정책적 방안을 제시하고자 현행법상 무연고 환자에 대한 논의와 방안 검토했다. 첫째로, 성년후견인제도의 적용을 살펴보았지만, 성년후견인은 신체를 침해하는 의료행위에 대한 동의를 대신할 수 있지만 의료행위의 직접적인 결과로 사망할 수 있는 경우에는 가정법원의 허가를 필요로 하기 때문에 임종과정에 있는 급박한 환자에게는 적절한 방안이라고 할 수 없다. 둘째로, 연명의료결정법 제14조에 따라 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정에 관한 심의에 대해 살펴보았다. 현행법상에서는 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정을 할 수 없기 때문에, 개정을 통하여 무연고 환자에 대한 연명의료중단등결정에 대한 사항을 동법 제14조에 반영하거나 무연고 환자에 대한 규정을 따로 신설하여 개정하는 것이 필요하다. 또한 의료기관윤리위원회에서 무연고 환자에 대한 결정해야 하지만, 그런 결정을 하는 것에 대해서 해당 의료기관에서 할 수 없다면, 공용윤리위원회에서 무연고환자의 연명의료중단등결정을 할 수 있도록 법률을 개정할 필요가 있다.

• 무역상무연구
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• 제54권
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• pp.261-282
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• 2012

The European Union (EU) has introduced the EU Emissions Trading Scheme (EU ETS) as one of the key policies to reduce the level of greenhouse gas emissions and in July 2008, they decided to include aviation in the scheme. As soon as the decision was announced the EU ETS was met by sharp opposition from world governments and international aviation. A group of US airlines, in particular, dropped a lawsuit against the British government over aviation's inclusion in the EU ETS. On 21 December, the Court of Justice of the European Union (CJEU) ruled that aviation's inclusion in the EU ETS which covers all flights arriving into and departing from the EU is legal and does not contravene international law. The scheme eventually came into effect on 1 January 2012. However, most countries are in opposition to the EU ETS and have agreed on counter-measures to undermine the EU's plan which may bring chaos to the aviation industry if such measures were to put into practice. This study therefore will analyze the likely effects that may be brought to the Korean aviation industry as a result of the inclusion of aviation in the EU ETS. Further, it hopes to contribute to the Korean aviation industry by studying other countries' counter-measures in advance.

• 한국보건간호학회지
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• 제34권2호
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• pp.251-262
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• 2020

Purpose: This study attempts to provide basic data for establishing and implementing an advanced directive (AD) system that helps identify dignified death attitudes and reduces death anxiety of the preliminary, through preparation of an AD. Methods: Data were collected from 135 preliminary elderly aged 55 to 64 years, recruited from health centers and welfare facilities. All data were analyzed using SPSS 22.0. Results: Overall scores of the participants were 2.26±0.64 for death anxiety scale, and 3.16±0.44 for dignified death attitude. Scores of individuals who prepared an AD were determined to be 2.19±0.64 for death anxiety, and 3.34±0.44 for dignity of death. The difference in scores obtained for dignified death attitude was significantly higher for the group that signed an AD, as compared to the group with no AD (F=14.81, p<0.001). Conclusions: Results of this study reveal that preliminary elderly who sign an AD have a higher dignified death attitude score as compared to subjects who do not sign an AD. Additionally, the former group of participants desire a dignified end to their life. This indicates a necessity to promote public campaigns for ADs, and to develop educational programs that assist the elderly to prepare for a dignified death and make autonomous decisions.

• 중소기업융합학회논문지
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• 제6권4호
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• pp.123-129
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• 2016

본 연구는 노인환자의 사전의료의향서에 대한 태도를 결정하는데 영향을 주는 요인을 파악하기 위해 충남 소재 요양병원 5곳과 종합병원 1곳에 입원한 65세 이상의 노인 환자를 대상으로 조화된 설문지를 이용하여 조사하였다. 사전의료의향서에 대한 태도는 2.84점으로 평균이상 수준, 가족기능은 2.73점으로 평균 이하의 수준이었으며, 자기효능감은 3.45점으로 평균 이상의 수준이었다. 연구 결과, 가족기능이 좋을수록 사전의료의향서에 대한 태도가 부정적(r=.-.324, p<.01)이었으며, 자기효능감이 좋을수록 사전의료의향서에 대한 태도가 긍정적인 것으로 나타났다(r=.340, p<.01). 본 연구는 사전의료의향서가 국내에 정착하는데 기여할 것이다.

• Tuberculosis and Respiratory Diseases
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• 제58권3호
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• pp.213-229
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• 2005

The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

• 의료법학
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• 제10권1호
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• pp.263-305
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• 2009

Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.